BACKGROUND: Metastatic Endometrial Cancer originates from the endometrial layer of uterus and metastasizes mostly to the rectum, bladder, ovaries, and liver parenchyma. The 5-year prevalence was found to be 34.7%. According to European Commission, metastatic endometrial cancer is the fourth most common cancer.

OBJECTIVES: To outline the unmet needs, current standard of care, and advancements in the treatment of metastatic endometrial cancer in the coming years.

METHODS: Secondary literature search was limited to the English Publications from Europe over the last 5 years.

RESULTS: The survival rate of endometrial cancer incrementally decreases with disease progression. In the advanced stages, patients experience poor quality of life due to disease complications and treatment side effects, which further drive the burden of disease. Numerous guidelines (SEOM, ESMO, BCGS) outline a stepped approach for management of mEC, commonly recommending cytoreductive surgery and platinum-based derivatives (mostly carboplatin) in combination with paclitaxel for initial treatment. For recurrent stages, radiation therapy and progesterone therapy are considered the gold standard. In platinum-resistant stages, the guidelines recommend angiogenesis inhibitors. Currently, the only approved drug for the management of mEC is Jemperli® (Dostarlimab), however, the mEC landscape is expected to have an influx of innovation in the coming years with 5 drugs in phase 1/2 trials.

CONCLUSIONS: Given significant disease progression and lack of therapeutic alternatives in the current landscape, mEC is associated with high levels of unmet needs and decreased quality of life. However, the development of numerous innovative MOAs will have significant impact in future management of mEC.